If an application is not acted upon by the regional director, or a designated agent, and the county mayor within a reasonable time after the filing of the application, or is denied in whole or in part, or if any award of medical assistance is modified or cancelled under any provision of this part, the applicant or recipient may appeal to the department in the manner and form prescribed by the department, and shall be afforded a reasonable notice and opportunity for a fair hearing by the department. Written notice of a right to a fair hearing shall be given by the county office to each applicant and recipient at such time as the county office takes any action concerning the amount awarded to the individual or the action on the application of the individual.